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Article Excerpt
This study examined the influence of gender, cultural variables (i.e., horizontal and vertical individualism), and personal psychological variables (i.e., psychological distress, social-network orientation, and self-concealment) on attitudes toward seeking counseling in Korea. For the 142 college student participants, gender, social network orientation, and self-concealment significantly influenced attitudes toward seeking professional help. Hierarchical multiple regression analysis suggested that higher scores on negative social network orientation and self-concealment were associated with lower attitudes toward seeking professional help. Men showed more negative help-seeking attitudes than women. Implications of the findings for developing and delivering counseling services in Korea are discussed.
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With about 50 years of history, the profession of counseling and psychotherapy in Korea has been growing rapidly in recent years and the numbers of counselors and counseling centers have been increasing (Kim, 1997; Kim et al., 2000). To enhance the accountability of the counseling services, national licensure for professional counselors was introduced in 2001. However, in spite of increased counseling services, many Koreans with mental health issues still do not consider seeking professional psychological help as a way of resolving their problems. For instance, Yoo (2001), investigating referral patterns of youths with problems, found that Koreans were not inclined to use professional counseling services, regardless of the nature of their problems. Because attitudes have been found to predict actual help-seeking (Cramer, 1999), a better understanding of Koreans' help-seeking attitudes may impact the way counseling services are designed and delivered in Korea and may improve the access and delivery of such services to those needing counseling services. Therefore, the purpose of this study was to examine the influence of gender, psychological variables, and cultural variables on attitudes toward seeking professional psychological help in Korea.
PERSONAL FACTORS INFLUENCING HELP-SEEKING ATTITUDES
Earlier studies on help-seeking attitudes focused on the influence of (a) demographic variables such as gender, race, education, socioeconomic status (SES), and religion (Cramer, 1999), and (b) personal and psychological factors. Women (Fisher & Turner, 1970) and people who have a higher SES (Tessler & Schwarts, 1972) and educational level (Leaf, Bruce, Tischler, & Holzer, 1987) have had more positive attitudes toward seeking professional help than men and people with a lower SES and educational level. In addition, Cramer's reanalysis of data from Kelly and Achter (1995) and Cepeda-Benito and Short (1998) revealed that higher psychological discomfort (Rickwood & Braithwaite, 1994), more positive social network orientation (Tata & Leong, 1994), and a higher level of self-concealment (Larson & Chastain, 1990) predicted more positive attitudes toward seeking professional psychological help.
With regard to psychological discomfort, using Australian adolescents, Rickwood & Braithwaite (1994) examined the relationship between gender, social network, openness to mental health service, psychological discomfort, and general (i.e., informal networks, such as friends or family and professional) as well as professional (e.g., mental health or educational) help-seeking. They found that being female and willing to disclose mental health issues were significantly related to general help-seeking but that only psychological discomfort was related to professional help-seeking. Similarly, a study conducted with Korean college students (Jang, 1999) revealed that the personal perception of the seriousness of a problem, rather than the nature of a problem, influenced attitudes toward seeking counseling service. This result suggests that people seek professional psychological help when they experience great psychological discomfort. Not everyone experiencing psychological discomfort, however, seeks professional psychological help (Lopez, Meledez, Sauer, Berger, & Wyssmann, 1998). For instance, adolescents and minorities in the United States, despite having greater emotional stress as compared with non-minority groups, have higher resistance toward utilizing and receiving counseling services (Akutsu, Snowden, & Organista, 1996).
Social network orientation, which may influence help-seeking, refers to the beliefs, attitudes, and expectation that individuals have about the utility of their social support system in a problem situation. This personal perception of the utility of social support systems is reported to be stable over time (Sarason, Pierce, Sherin, Sarason, & Waltz, 1991). A negative social network orientation results from experiencing ineffective and punitive social support and leads to low trust, independence, and low social skills (Vaux, 1985). Negative social network orientation also reflects the belief that the social support system's intervention is undesirable, impossible, or potentially dangerous. This result, in turn, may lead to negative attitudes toward seeking psychological services (Tata & Leong, 1994).
The level of a person's self-concealment is also thought to influence attitudes toward seeking psychological help (Cepeda-Benito & Short 1998; Cramer, 1999; Kelly & Achter, 1995). Self-concealment denotes one's predisposed refusal to share personally distressing information with others (Larson & Chastain, 1990). The findings from studies on self-concealment are, however, inconsistent. According to Kelly and Achter (1995), high self-concealers reported more negative attitudes toward professional help-seeking than low self-concealers, but high self-concealers reported a higher probability of actually requesting counseling. These findings indicated that, even though high self-concealers were afraid of counseling because it requires disclosing personal information, they were more likely to request counseling because of their greater perception of the need for counseling. In contrast, Cepeda-Benito and Short (1998) argued that high self-concealers tended to avoid counseling and that there was no evidence of these individuals in comparison to low self-concealers showing a higher probability of seeking counseling. Therefore, individuals who report a greater perceived need for counseling may not actually seek counseling.
CULTURAL FACTORS INFLUENCING HELP-SEEKING ATTITUDES
In two studies that explored the relationship between adherence to Asian cultural values and attitudes toward seeking help, Asian-American students' level of acculturation was significantly correlated with their tolerance of stigma associated with psychological help and their willingness to see a counselor (Kim & Omizo, 2003; Zhang & Dixon, 2003). These findings support other cultural comparative studies that suggested that Asian Americans tend not to utilize Western counseling services (Yamashiro & Matsuoka, 1997; Ying & Miller, 1992). In another study, Tata and Leong (1994), using Chinese-Americans, discovered that the...
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